Questions And Answers

Common Questions

What is prosthodontics?

Prosthodontics is a dental specialty recognized by the American Dental Association that deals with cosmetic dentistry, dental implants, crowns, bridges, dentures, and temporomandibular joint disorders.

What is a prosthodontist?

A prosthodontist is a dentist who has specialized in treating and handling dental and facial problems that involve restoring missing tooth and jaw structures. A prosthodontist is an expert in cosmetics, dental implants, crowns, bridges, dentures, and temporomandibular disorders.

Where can I find a prosthodontist near me?

Why choose a prosthodontist?

Choose a prosthodontist because of their extensive experience, advanced knowledge, improved efficiency, and their use of advanced technology.

Prosthodontists are dental specialists in the restoration and replacement of teeth who have completed dental school plus three additional years of advanced training and education in an ADA-accredited prosthodontic graduate program.

Prosthodontists provide an extremely high level of care to patients with missing teeth, or having significant damage to their existing teeth. Prosthodontists work with congenital defects as well as problems arising from trauma and neglect. Prosthodontists are highly trained in state-of-the-art techniques and procedures for treating many diverse and complex dental conditions and restoring optimum function and esthetics. These include: crowns, bridges, complete and removable partial dentures, dental implants, TMD-jaw joint problems, traumatic injuries to the mouth’s structure and/or teeth, snoring or sleep disorders, and oral cancer reconstruction and continuing care.

What is a dental technician?

How do prosthodontists select labs?

Prosthodontists work only with laboratories that demand the finest quality and the most precise work available. The attention to detail and the experience of the lab is important for providing the best for prosthodontists' patients.

Are prosthodontists trained to treat TMD, and if so what techniques do they use? By what parameters are they limited to treat extraoral head and neck areas for this condition?

Yes, prosthodontists are trained to treat temporomandibular joint disorders. Several treatment options exist and all of these options are conservative and do not produce permenant damage to the teeth. These treatment options include physical therapy and exercise, pharmacologic treatment, and occlusal devices.

Dentures

I want dentures. Where do I start?

The best starting point to see if dentures are an option for you is to see your general dentist or a prosthodontist. A prosthodontist is a specialist with an additional three years of training after dental school who focuses on the restoration and replacement of teeth, including dentures for even the most complex cases. A prosthodontist also will be able to help determine if another treatment option might be more suited to your particular situation.

What types of dentures are there?

Dentures may replace all the teeth or only some of the teeth. The dentures that replace all the teeth are known as complete dentures and they rest on the gums that cover the jawbones. The stability and retention of these dentures can be improved by attaching them to dental implants. Dentures that replace some but not all of the teeth are known as partial dentures. They attach to the teeth that are still present and also cover and rest on the gums and bone where the teeth are missing. Dental implants can also be used to restore and stabilize partial dentures as well.

What is the average cost of dentures?

Denture fees vary widely based on location. Denture fees can vary depending on your needs and the prevailing fees in your community. The best way to determine fees for the services you require is to visit with your dentist or prosthodontist and discuss the care you may need. You may also contact your state or local dental society to find out if the organization has any resources for the public related to the cost of dental services. You may want to seek the care of a prosthodontist, a dentist with three years of training beyond dental school who specializes in the care and maintenance of dentures.

What are the least expensive dentures?

Fees for dental services can vary based on many factors including the complexity of your particular treatment, the time required to accomplish the treatment, and the location of the dental practice. Payment terms also vary according to the business requirements of the specific practice. You may wish to contact your state or local dental society to find out if the organization has any resources for the public related to the cost of dental services. You can use the ACP's search to find a prosthodontist near you.

It is not possible to whiten dentures like natural teeth because dentures are made of plastic. To minimize staining, properly clean your dentures daily to remove food and plaque bacteria. Brushing with a denture brush or soft toothbrush will prevent dentures from becoming permanently stained and keep your mouth healthy. Moisten the brush and apply a non-abrasive soap or denture paste (regular toothpaste is too abrasive). Brush every surface, inside and out, scrubbing gently. A variety of over-the-counter denture cleanser products may be safely used (by following the manufacturer’s instructions) to remove most stains. A weekly 10 minute soak in dilute household bleach is recommended but discuss it with your dentist first. However More stubborn stains may require removal by your dentist or prosthodontist. a specialist in denture care and maintenance.

Can I brush my dentures with toothpaste?

No, toothpastes are designed to be used on teeth, and they often contain materials and chemicals that help whiten and strengthen teeth, but may harm dentures, which are made of a very durable plastic. Even though the plastic is strong, it is not as strong as the enamel of teeth and may be scratched by using toothpaste to clean your dentures. You should use a dish washing liquid and a special denture brush to clean your dentures by hand every day. After rinsing them thoroughly, soak your dentures in water-based cleaning solution overnight. Do not use bleach on your dentures unless your dentist or prosthodontist gives you special instructions on using bleach. Dilute household bleach can be used to clean and disinfect your denture, but don’t use bleach until you see your dentist for instructions.

How do I repair broken dentures?

The best solution is to return to the dentist or prosthodontist who made your dentures and have the cracked denture repaired professionally. It may seem easy to fix, but it is important that the repair is done correctly to prevent problems with chewing and to avoid any sore spots. The dentist also needs to check the denture and adjust it after it is repaired. The denture may be too old and may no longer fit closely to your gums, and you may need a new denture.

Can I sleep in my dentures?

Yes, you can wear your dentures at night but it is preferred that they be removed. You should remove your dentures at night and this will give your gums and bone a chance to relax from the pressure of the denture during the day. If you need to wear your dentures for social reasons or to prevent your jaws from over closing, you should find time during the day to properly clean your mouth and your prostheses. You should never wear your dentures 24 hours a day without preforming proper oral hygiene. Dentures should be cleaned at night and stored in water during the night. Dentures can be made to look like your teeth or, if you want changes in your teeth, the dentures can be made to improve your appearance. You should work with your dentist or prosthodontist and tell him/her how you would like to look. You may want to seek the care of a prosthodontist, a dental specialist with three years of additional training in the restoration and replacement of teeth, including dentures.

Can I eat normally with dentures?

Most patients need to learn how use dentures properly and as a result, it takes a little time to get used to them. After a while, you should be able to eat fairly normally, but it may take more time to get comfortable with harder foods or sticky foods. Using a small amount of denture adhesive (no more than three or four pea-sized dabs on each denture) may help stabilize the dentures and help hold them in place while you learn how to get comfortable with them and may make the learning process easier.

Can I chew sugarless gum with dentures?

Dentures and chewing gum do not usually work well together, no matter which brand of chewing gum you decide to try. The gum typically sticks to the acrylic plastic in the denture and may break a seal on the dentures, which will loosen them as a result. Gum may remain stuck to the denture and eventually harden and discolor. Ultimately, if you wear dentures, you should avoid chewing gum.

How much pain is involved with getting dentures?

When you’re first fitted for new dentures, it’s normal to experience minor irritation, which should fade as your mouth becomes accustomed to them. The period of pain varies. If you’ve previously worn dentures and now have a new set it may take longer. Similarly, if you had some natural teeth present that were removed at the time the new dentures, the areas where the extractions were performed may be painful or uncomfortable for up to several weeks after the removal of the teeth. Regular visits to your dentist or prosthodontist to adjust the dentures as you go through the normal healing process are recommended. To locate a prosthodontist near you visit www.gotoapro.org.

What are permanent dentures?

The term “permanent dentures” is deceptive and misleading. As we know, most things in life are not permanent, teeth and dentures alike. “Permanent dentures” are retained by screws or dental cement onto dental implants and cannot be removed by a patient; they can only be removed by your dentist or prosthodontist. Eventually even these “permanent dentures” may wear or break or become stained and discolored and will require replacement. Typically, soreness should be resolved within two weeks; if it persists, likely something in the denture needs to be adjusted. You should see your prosthodontist as soon as possible.

How do you know when it’s time to reline dentures?

If the dentures no longer fit as well as they once did, you may need to have a procedure done to refit the base of the denture, called a “reline". Check with your dentist to see if your dentures can be relined. It is best not to reline your dentures with over the counter reline kits. However, this procedure will enable your dentures to fit better, and tighter, than they have previously. This procedure can be done by your dentist or prosthodontist, a specialist in denture care and maintenance.

I recently had my full dentures relined. Since then, my mouth waters all the time. The saliva is major. Is this something that will go away or should I have new dentures made?

You may consider having the upper denture checked to see if it positioned properly. Sometimes dentures can be made in a position that does not allow the lips to close resulting in excess saliva. If swallowing is not impaired, you should be able to clear your mouth and the amount of saliva will generally decrease. If this does not happen, you should see your dentist or prosthodontist to correct the problem.

Can you have teeth pulled out and dentures put in on the same day or in the same week?

Yes, it is possible to have your teeth removed and dentures put in the same day. The dentures are called immediate dentures and you should talk to your dentist or prosthodontist to see if that treatment is the best for your mouth. A prosthodontist is a dentist with three years of training beyond dental school who specializes in the care and maintenance of dentures.

I am new to having dentures, so I am unsure how they should fit. The bottom seems to be very loose. They are easily loosened and "swim araound" in my mouth shortly after using powder adhesive especially after or while eating. Is this normal?

In most cases, the lower denture is much less stable than the upper denture. This is due to the shape of the gums on the lower ridge and movement of the denture cause by the tongue. Ask your dentist about supporting your lower denture with dental implants. Implants can be used to stabilize and retain the lower denture allowing you to chew more efficiently and feel the confidence of knowing that your denture will stay in place.

How can I get a perfect match to my remaining natural front upper teeth with a partial denture?

Prosthodontists and their teams are highly trained in the art of color and shade matching. Assuming it is a new partial denture, they can work to produce a match to your remaining natural teeth. (If it is an existing partial denture, we would recommend having a new one made, as the expense would be about the same to recolor the old one.) To find a prosthodontist near you, visit www.gotoapro.org.

I had 2 lower implants inserted to connect the full denture. The screws in the denture keep loosening and not holding the denture intact with the implant. Is this normal?

It sounds like the implants were intended to help stabilize the denture, in which case, they should reduce the movement. If your dentures rub your cheeks or if you’re biting your cheeks, you should return to the dentist or prosthodontist who made the dentures to continue to have the fit and bite refined. You should visit your dentist or prosthodontist to remedy each of these difficulties. To learn more about a prosthodontist and to locate a prosthodontist near you visit www.gotoapro.org.

I am new to dentures and don't like wearing them. After about 4 hours, they feel very heavy in my mouth and I have a hard time closing my mouth. Is this normal?

While you may simply adjust to the new dentures, it is likely that if teeth were removed the same day that the dentures were given to you, then you will need follow up with your dentist to assure that they continue to fit properly as you heal. If you did not have any teeth extracted and simply had new dentures made, there should be fewer adjustments. These adjustments should be more minor in nature. The heavy feeling you mention may be because you have not previously worn dentures or partial dentures. If that is the case, it will take several weeks for you to completely adapt to the feel of them.

I've worn dentures for 50 years and now I'm losing gum and bone. Can this be fixed?

Research shows that once the teeth are removed, the jaw bone shrinks and changes shape. Typically, dentures should be checked every year, and often they should be remade when they lose their fit and are loose in your mouth after 5-10 years of use. By using dental adhesive, you may have masked the loose fit of your dentures. Even though you have adapted to these dentures, you are not receiving the function and appearance you deserve. Also, it is important that you take your dentures out at night to allow your gum tissues to rest and decrease the possibility of sore spots. You may want to seek the care of a prosthodontist, a dentist with three years of additional training beyond dental school in the restoration and replacement of teeth.

I have only had my dentures for 3 months and have already had to get them relined. The bottom dentures will not stay in my mouth long enough for me to eat no matter what kind of adhesive I use. Is it possible they were not fitted right from the beginning?

Relines of dentures should improve the fit of the base of the denture to the jaw. However, if your jaw has been without natural teeth for some time, it may be difficult to make the denture stable if there is little jawbone. Soft tissues beneath dentures can also become easily irritated by wearing dentures continually (24 hours a day). You should refrain from wearing dentures at night as this gives the skin a chance to recover from wearing them during the day. Your dentist or prosthodontist should make sure that the skin inside the mouth is healthy and take steps to treat it properly before relining. If there is enough jawbone available, relines can often be done well. If not, it may be necessary to revisit the need for either remaking or redesigning the denture. A prosthodontist, a dental specialist with three years of additional education after dental school, is trained to serve patients with a combination of needs such as dental implants and dentures.

Can a GP do denture and implant teeth work?

Regulations vary by state. However, you may wish to see a prosthodontist for treatments such as dentures and implants because prosthodontists are dental specialists in the restoration and replacement of teeth who have completed dental school plus three additional years of advanced training and education in an ADA-accredited prosthodontic graduate program. Extensive training and experience provide prosthodontists with a special understanding of the dynamics of a smile, the preservation of a healthy mouth and the creation of tooth replacements.

My teeth were pulled out about 20 years ago. I didn't wear any dentures. Is it possible for me to wear dentures even though my gums have already shrunk?

It’s hard to predict how much of the upper and lower jaw will remain after 20 years without teeth. When teeth are removed, often the bone that held them in slowly shrinks over time. This doesn’t happen to everyone, but it’s normal after tooth removal. It’s important that dentures are made properly to fit well and keep minimum stress on the bone. It’s not likely that you’ll have all the bone you started with after 20 years of not wearing a denture. Your dentist or prosthodontist should annually examine your mouth to assure ideal oral health, including the bone level that would be below your dentures.

I have two implants to hold my bottom dentures. Can't get dentures in, what am I doing wrong?

You should ask for an appointment with the dentist who made the dentures for you, as he or she has a responsibility to make the dentures as well-fitting as possible. If you are not satisfied with the care you are receiving, you may want to consider consulting a prosthodontist, a dentist with three years of training beyond dental school who specializes in the care and maintenance of dentures.

I've had full dentures for about 8 years. I am on my 2nd pair of dentures with hopes of improving my smile. The dentist wants me to get 2 implants for the bottom denture. I have horizontal creases in my lower jaw. Should I have a cosmetic chin implant?

Decisions such as those should be made in careful consultation with your dentist or prosthodontist, a dental specialist with three years of training beyond dental school focused on denture fabrication, care and maintenance of the dentures and the mouth.

What would make the backs on my lower implant dentures pop up when eating?

Your dentures may be ill-fitting or the position of the implants may not be the most favorable. Usually this can be resolved by improving the fit of the denture or by adding more implants. Your prosthodontist can help you with this situation.

After applying adhesive, it's very difficult to remove dentures. I want to know some tips to easily remove them without so much pain.

If you are using your denture adhesive correctly, there should not be a lot of adhesive left on your gums and palate when you remove your denture. Patients use a variety of methods to remove the adhesive—a piece of gauze, a tissue, a damp washcloth, or a wet toothbrush.

Dental Implants

What are dental implants?

A dental implant by itself is not a tooth! A dental implant is a prosthesis. Essentially, it is a small titanium post/fixture that is inserted into the jawbone, on top of which, a single crown (cap), a fixed bridge, a partial denture, or full denture can be attached. Once the implant integrates to your bone, a structure called abutment is connected to the implant and then the artificial tooth/teeth are attached. Therefore, there are 3 parts to an “implant tooth”- the dental implant itself, the abutment, and the artificial tooth.

Who is a good candidate for dental implants?

What are the advantages of dental implants?

Humans are “blessed” with 2 sets of teeth- baby teeth and adult/permanent teeth. When a single permanent tooth or all teeth are lost due to dental decay or gum disease, dental implants can now replace them as the 3rdset of fixed teeth!

Dental implants can last a lifetime and can improve your appearance, your confidence, and your ability to eat the foods you like, and participate in an active lifestyle, without worry about your teeth.

What are the disadvantages of dental implants?

Like any minor oral surgical procedure, there is a risk of infection, inflammation and pain but your Prosthodontist will discuss how these can be managed for your specific situation. If there is no available bone to place the implant, then bone and gum grafting procedures may be required, that can increase the cost of your treatment. However, the upfront investment can pay off in the long term.

What is the success of dental implants?

It varies from individual to individual and with health and habits. For a healthy individual with good oral hygiene and good health, dental implants are predictably successful and survival rates above 90-95 percent are reported. You may consider seeking the care of a prosthodontist, who is a dental specialist with 3 years of additional education after dental school, and who is trained to treat patients requiring dental implants.

How much do implants cost and does insurance cover the cost?

In general, the cost of replacing a single tooth with a dental implant is almost the same as replacing it with a regular fixed bridge. Dental implant treatment may qualify for some insurance coverage, but situations vary.

The cost will vary by patient needs, bone quantity, and region. A prosthodontist will make an assessment based on your unique needs. To find a prosthodontist near you, click here.

What if I want "metal-free" implants?

Firstly, there is no such thing as “metal-free” teeth. Almost all materials used for teeth replacements have some sort of metal ions in them. Dental implants are made of titanium alloy (similar to hip implants, shoulder implants, and knee implants), which is highly biocompatible, and allergy to titanium is extremely rare! Currently, there are no proven alternatives to titanium dental implants.

Do dental implants last?

Unlike natural teeth dental implants are not susceptible to dental disease such as decay; however, the health of the gums is vital to maintaining last implant success. Conscientious home care by the patient and regular professional cleanings and check-ups are essential elements for dental implant sustainability. Each patient is different, and success relies upon diagnosis and planning, medical history and a variety of other factors.

What is all on four?

All on 4 is a trademarked treatment procedure that essentially involves replacement of all missing teeth in one jaw by using only 4 implants. This procedure is especially beneficial in patients who have lost a lot of bone in the back areas of the mouth.

Can dentures be made into implants?

Dentures cannot be “made into implants.” Implants are metal screws placed into the jawbone to help anchor and support artificial teeth (dentures). It may be possible to have implants placed beneath existing dentures to aid in the stabilization and support for those dentures. This could only be done if the current dentures were otherwise in excellent condition. You should consult with your prosthodontist to have your existing dentures carefully examined.

Are dental implants removable like regular dentures or do they stay in your mouth?

I have 4 implants underneath my bottom denture and my denture is still loose. Why?

If the implants had been placed a long time ago and you have not returned for folllow-up/maintenance visits, such problems can occur. Unfortunately, in time the bone shrinks beneath dentures causing the dentures to slip and slide resulting in painful ulcers. Additionally, the attachment parts get worn down with use or damaged and require replacement. Regular visits to your prosthodontist is recommended.

How do dental implants help if I have full dentures or partial dentures?

Actually implants are most popularly used in patients who wear full dentures or partial dentures. Dental implants can be used to provide retention and support for a removable implant overdenture, which basically snaps on the implants like a trailer-hitch! Therefore the partial or full denture does not move and reduces the dependency on denture adhesives/denture glue.

OR, dental implants can be used for a Fixed Denture, where a patient’s dentures are fixed/bolted to the implants through titanium components. Only the dentist can remove this from the mouth and not the patient! The patient just takes care of the “fixed teeth” just like natural teeth!

Board Certification

What is board certification?

In general, Board certification means that your specialist has successfully passed a rigorous examination established by an independent authority (board) for the specialty. A Board Certified Prosthodontist means that your Prosthodontist has successfully passed a rigorous four-part examination conducted by the American Board of Prosthodontics.

How can I determine if my prosthodontist is board certified?

My dentist is listed as a prosthodontist. Does that mean he or she is board certified?

Some states allow the listing but it does not necessarily mean that an individual is board certified. Any graduate of an accredited dental school is permitted to practice prosthodontics. Some individuals choose to receive additional post-graduate training and complete a three-year program in prosthodontic training. Many of these individuals choose to become board certified but some do not. Board certification establishes that the individual has successfully completed a four-part examination and is subjected to re-certification every eight years to ensure that he/she is current in practices that affect the specialty.

Improving your smile

What is a crown?

When a tooth exhibits moderate to severe destruction such as a large filling with recurrent decay or extensive wear, a crown, also known as a protective cap, gives you the strength, beauty, translucency, and feel of a natural tooth. Made from a variety of materials, your prosthodontist can help determine the correct crown for your mouth.

What can be done to brighten my smile?

Tooth whitening lightens discolored enamel and dentin. Studies have shown that proper use of dentist-monitored, whitening systems can enhance your smile. Almost anyone can benefit. After a thorough examination and diagnosis your prosthodontist can determine if you are a good candidate for home whitening.

What are veneers?

Veneers may be an option is you are not happy with the spaces, color or shape of your teeth. Following a slight preparation of the outermost surface of your teeth, a prosthodontist bonds a thin layer of porcelain permanently to the front of your teeth. Veneers may be used to correct minor flaws of individual teeth, but often are used on multiple teeth to create a uniform smile.

What is an option for replacing a defective filling?

Unsightly fillings can be replaced by a tooth-colored material bonded to the tooth. Instead of using the more traditional cement, this bonding process may actually improve the strength and beauty of the tooth.

What are some options for replacing missing teeth?

From implants to permanent bridges, you have several options to replace missing teeth and blend them with your natural teeth. Using advanced materials and tooth-color matching techniques, your prosthodontist can recommend the appropriate method for optimal function and esthetics.

How does a prosthodontist fix broken, discolored, or misshapen teeth?

20 years ago, I got top back partials (6 teeth) & bottom back partials (4 teeth). 10 years ago, I got 8 top & 8 bottom veneers, but lost the smile as you can't see any top teeth when smiling.

There are many options to improve the appearance of your smile. To find the right solution for your mouth, you may want to seek the care of a prosthodontist, a dentist with three years of training beyond dental school who specializes in the esthetic restoration and replacement of teeth.

My mom is losing some teeth due to oral cancer. Is there some type of replacement she can get?

She should see a a prosthodontist for consultation. Some patients have to wait a period of time before dentures can be fitted to avoid these concerns. Details of the cancer treatment are important and may guide the timeline and treatment approach. A prosthodontist is a dental specialist with three years of additional training in the restoration and replacement of teeth, including complex cases.

Tooth #10 is slightly loose, has a calcified root, and I'm told it can't have a root canal. That tooth has much decay and I was instructed that I would need a fixed bridge covering teeth #11-6 (to act as a splint). Could #10 just be fixed with only a crown?

Every patient has unique needs. The best way to determine a treatment plan is in consultation with your dentist or prosthodontist, a dentist with three years of training beyond dental school.

What options do prosthodontists offer to restore your teeth?

How is a prosthodontist different from other dentists and dental specialists?

The term “prostho” means replacement and “dontist” means dealing with teeth. Essentially, prosthodontists are THE recognized experts when anything needs to be replaced in your mouth. This can range from a single tooth, multiple teeth, or all teeth and gums in the mouth! While many other dentists can do some or all of these treatments, prosthodontists are the specialists dedicated to this type of care.

Prosthodontists expertly restore and replace teeth. They have trained 3 additional years after completing dental school. Prosthodontists are also considered the “quarterback” of the dental treatment plan. They regularly lead teams of general dentists, specialists, and other health professionals to develop solutions for your dental needs.

What does full mouth reconstruction mean?

In general, any dental treatment that affects all teeth in the mouth is called full mouth reconstruction or full mouth rehabilitation. Prosthodontists are the recognized experts in such treatments. The treatments can range from crowns, bridges, implants, and dentures that will essentially provide a “smile makeover” for the patient. You may want to seek the care of a prosthodontist for your specific needs.

The American College of Prosthodontists is the organization of dentists with advanced specialty training who create optimal oral health, both in function and appearance including dental implants, dentures, veneers, crowns and teeth whitening.

Copyright 2015, American College of Prosthodontists, All Rights Reserved